Safety and efficacy of short course combination regimens with AmBisome®, miltefosine, paromomycin for the treatment of visceral leishmaniasis (VL) in Bangladesh

by Rahman R, Goyal V, Haque R, Jamil K, Faiz A, Samad R, Ellis S, Balasegaram M, den Boer M, Rijal S, Strub-Wourgaft N, Alves F, Alvar J, Sharma BPLOS NTDs 2017, doi: 10.1371/journal.pntd.0005635.

Summary: AmBisome® therapy for VL has an excellent efficacy and safety profile and has been adopted as a first-line regimen in Bangladesh. Second-line treatment options are limited and should preferably be given in short course combinations in order to prevent the development of resistant strains. Combination regimens including AmBisome®, paromomycin, and miltefosine have proved to be safe and effective in the treatment of VL in India. This study reports on the safety and efficacy of these combinations (Amb+MF, Amb+PM, and PM+MF, vs Amb) in 601 patients in field conditions in Bangladesh. None of the combinations were inferior to AmBisome® in both the intention-to-treat and per-protocol populations. All the combinations demonstrated excellent overall efficacy, were well tolerated and safe, and could be deployed under field conditions in Bangladesh.

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